Individual
LANITA JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADULT GERONTOLOGY NP
Contact information
Practice address
770 WALNUT ST, MACON, GA 31201-7307
(478) 787-4266
Mailing address
PO BOX 4363, MACON, GA 31208-4363
(478) 787-4266
(478) 787-4199
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN150740
GA
363LG0600X
Gerontology Nurse Practitioner
RN150740
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN150740
GA
Other
Enumeration date
09/01/2016
Last updated
12/22/2016
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